Laser assisted extraction - Laser Dentistry Forum

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May 18, 2003 at 5:24 am #2796 Reply

Glenn van As
Spectator

Hi folks: here was a case I did the other day for a lady who is in her late 70s.

The tooth had a cast gold post and core and a crown which fractured off at the gingiva and patient was given options of post removal (tough), osseous surgery, possible graft of attached tissue, new post core and crown support her partial denture or..

Extraction and addition of the tooth to her partial with a new valplast clasp on the lateral.

She chose the simpler option and I prepared to extract the tooth.

When the partial came back with the tooth added on, we placed anesthetic and then used the laser to remove tissue around the root ( it had overgrown it) by using the laser at
30 Hz and 80 mj without water (2.4 watts) and then 30 Hz and 100 mj with water for the 3 watts pulsed for bone relief.

I was then able to get the forceps on the tooth and roll it out. The socket is clean with no bone or tooth fragments. No flap was needed and the patient left happy happy happy……I got it out in one piece.

Now Mark is doing these exos without anesthetic (grin) but at least I didnt need a handpiece!!!

All the best,

Glenn

May 19, 2003 at 10:10 pm #6118 Reply

ASI
Spectator

Hey Glenn,

Another great application of Er:YAG.

Too bad a cuspid has to go.

How do you find the valplast clasp in terms of durability?
Almost invisible sitting over the tissue though.

Good work again.

How do you find the photo? Should I lose the girls? They are my new assistants as soon as basketball season is over. I wish.
Andrew

May 19, 2003 at 10:31 pm #6119 Reply

Glenn van As
Spectator

Hi Andrew…….I havent had the valplast partials in for more than about 2-3 years.

Patients like them. They are ok if you use the ValClean cleaner on them.

You can add to them and esthetically they are nice.

I typically will do a combo cast/valplast as in this one.

Hated to lose the canine but it was a toughie to save.

As for the girls…….now that the lakers are toast maybe they are looking for a job…….do you really need both??

Maybe I can borrow one?

I like the pic , it looks good on you……….THE SUIT THAT IS!!

Glenn

May 20, 2003 at 12:53 am #6121 Reply

Swpmn
Spectator

Excellent case, Glenn. Nice use of your Er:YAG as a “periotome” to relieve those tough supra-crestal fibers. Conventional treatment might have consisted of troughing around the root with a carbide bur – in your case the patient benefitted by not experiencing the acoustic whine of the high speed. Also treatment with the Erbium may have resulted in less trauma to tissue, bone and possibly less post operative discomfort.

Al

May 20, 2003 at 1:40 am #6120 Reply

Glenn van As
Spectator

Hi Allen………thanks. One thing I have noticed with the erbium is a cleaner socket and less trauma to the bone , tissue and less debris in the socket.

I have done this a couple of times and thats just what I noticed clinically. I got enough root available for the forceps to grab hold of and was able to get a tough tooth out in one piece. You can see the gold post on the last photograph in the root.

It worked well and did so last time too, neat way to take out the root I think.

Glenn
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